Perhaps it’s the fashion for minimalism, but we’ve noticed there’s a huge number of books about decluttering at the moment. From the practical to the extreme to the frankly eccentric, there seems to be a system to help tackle excess stuff for every day of the week.

Of course, there’s clutter and then there’s hoarding, a much, much more serious disorder that can prove difficult to treat, as we found out from talking to Satwant Singh, a Nurse Consultant in Cognitive Behavioural Therapy and Mental Health, and an expert in compulsive hoarding disorder.

‘Hoarding’ seems to be a term that’s bandied about, but in a medical sense how many people are affected by this disorder in the UK?

The first research that was done put the number at about 1%, but the current research points to it being between something like between 2-6%. I personally think it’s much higher.

Really? That’s quite a significant percentage of people.

Yes, it is. Obviously it ranges in its severity, so I think we’d find that there are cases where it doesn’t really impact a person’s life to such a detrimental extent: things like text messages or emails can easily get out of hand, but because they’re digital it doesn’t have the same impact as physical items.

When does the balance tip from collection to hoard?

It’s only when it impacts our world or our ability to cope or manage that that we tend to think about it and need to do something about it. Many adults have a collection of some sort – it’s a normal behaviour – but the difference with collections is that there’s an emotional attachment to them. There’s also often a rationality to adding to the collection that’s absent from hoarding behaviour.

What do you mean by that?

Let’s say I have a collection of chinaware that’s missing a couple of pieces to make it complete. A collector might be willing to exchange or let go of some other item if those missing pieces became available.

So it’s more of an ability to curate?

Yes. We find that people with hoarding issues find it very difficult to let go, sometimes almost irrationally.

In the extreme form, people’s homes are no longer functional for what they’re intended for. If they find they can’t bring people home, or there’s no room to sleep in, then there’s a problem which needs professional help. The difficulty is that we often see that in those cases the people in question might not see that it’s a problem, despite spending as much time as they can outside of the home environment.

Is there a typical item that gets hoarded?

People tend to hoard things like clothes, shoes, bags those kind of things, but people do hoard things which aren’t so normal, like their hair or anything that’s come into contact with their bodies – urine, faeces – but that’s obviously a very extreme hoarding situation.

Crikey. It sounds like it. What’s a key treatment strategy?

I’ve been working with individuals who have hoarding disorders since 2005 and we’ve found that one of the most effective means of treatments are those that use visual strategies. We get people to take photographs of their living spaces and the reason for this is that there’s a real problem of ‘clutter blindness’, which is where you become so accustomed to the environment in which you spend the most time that you get used to it, be it mess, smell or whatever.

When you look at photographs of your clutter in a neutral space, you’re able to get some distance from your environment and people tend to have a different idea or concept of what’s wrong. It’s simple, but remarkably effective.

That sounds like a strategy that might work well even for a regular amount of clutter, too. Do you think there’s a link between clutter and wellbeing?

There’s certainly a connection. I mean, people with hoarding issues are just like anyone else – they’ll be suffering with depression or anxiety or other forms or conditions. OCD is a very common issue with people who are also hoarding.

You said at the beginning of this conversation that you thought the numbers of people who affected by this is higher than the official figures show. Is it a problem of modern life?

I think it’s always been there, but it is getting worse as we’re getting more consumerist. Simply put, we’re buying more. People are also starting to recognize it as a condition, so we’ve also got the fact that more people are coming forward with the diagnosis.

So, if someone thinks they might need some help on this issue, what should they do?

Unfortunately there are very few services that specialize in treating hoarding disorder in the UK – most are diverted through to a more generic mental health services. The issue with hoarding is that it needs longer treatment and it’s not just seeing a therapist, it’s also seeing someone else outside that environment, to help them carry out the tasks that they need to be doing in the home in order to recover.

Satwant can be found on Twitter and if you’d like more information about treatment, visit the clinic website at Life Matters Consultancy. The good old NHS provides useful information about compulsive hoarding disorder too.

Featured Image by Eli Francis on Unsplash